PDF(Pubmed)
Abstract：
BACKGROUND: Liver transplantation (LT) is indicated in patients with severe acute or chronic liver failure for which no other therapy is available. With the increasing number of LTs in recent years, liver centers worldwide must manage their patients according to their clinical situation and the expected waiting time for transplantation. The LT clinic at the Centre hospitalier de l\'Université de Montréal (CHUM) is developing a new health care model across the entire continuum of pre-, peri-, and posttransplant care that features patient monitoring by an interdisciplinary team, including an accompanying patient; a digital platform to host a clinical plan; a learning program; and data collection from connected objects.
OBJECTIVE: This study aims to (1) evaluate the outcomes following the implementation of a patient platform with connected devices and an accompanying patient, (2) identify implementation barriers and facilitators, (3) describe service outcomes in terms of health outcomes and the rates and nature of contact with the accompanying patient, (4) describe patient outcomes, and (5) assess the intervention\'s cost-effectiveness.
METHODS: Six types of participants will be included in the study: (1) patients who received transplants and reached 1 year after transplantation before September 2023 (historical cohort or control group), (2) patients who will receive an LT between December 2023 and November 2024 (prospective cohort/intervention group), (3) relatives of those patients, (4) accompanying patients who have received an LT and are interested in supporting patients who will receive an LT, (5) health care professionals, and (6) decision makers. To describe the study sample and collect data to achieve all the objectives, a series of validated questionnaires, accompanying patient logbooks, transcripts of interviews and focus groups, and clinical indicators will be collected throughout the study.
RESULTS: In total, 5 (steering, education, clinical-technological, nurse prescription, and accompanying patient) working committees have been established for the study. Recruitment of patients is expected to start in November 2023. All questionnaires and technological platforms have been prepared, and the clinicians, stakeholders, and accompanying patient personnel have been recruited.
CONCLUSIONS: The implementation of this model in the trajectory of LT recipients at the CHUM may allow for better monitoring and health of patients undergoing transplantation, ultimately reducing the average length of hospital stay and promoting better use of medical resources. In the event of positive results, this model could be transposed to all transplant units at the CHUM and across Quebec (potentially affecting 888 patients per year) but could also be applied more widely to the monitoring of patients with other chronic diseases. The lessons learned from this project will be shared with decision makers and will serve as a model for other initiatives involving accompanying patients, connected objects, or digital platforms.
UNASSIGNED: PRR1-10.2196/54440.
OBJECTIVE: This study aims to (1) evaluate the outcomes following the implementation of a patient platform with connected devices and an accompanying patient, (2) identify implementation barriers and facilitators, (3) describe service outcomes in terms of health outcomes and the rates and nature of contact with the accompanying patient, (4) describe patient outcomes, and (5) assess the intervention\'s cost-effectiveness.
METHODS: Six types of participants will be included in the study: (1) patients who received transplants and reached 1 year after transplantation before September 2023 (historical cohort or control group), (2) patients who will receive an LT between December 2023 and November 2024 (prospective cohort/intervention group), (3) relatives of those patients, (4) accompanying patients who have received an LT and are interested in supporting patients who will receive an LT, (5) health care professionals, and (6) decision makers. To describe the study sample and collect data to achieve all the objectives, a series of validated questionnaires, accompanying patient logbooks, transcripts of interviews and focus groups, and clinical indicators will be collected throughout the study.
RESULTS: In total, 5 (steering, education, clinical-technological, nurse prescription, and accompanying patient) working committees have been established for the study. Recruitment of patients is expected to start in November 2023. All questionnaires and technological platforms have been prepared, and the clinicians, stakeholders, and accompanying patient personnel have been recruited.
CONCLUSIONS: The implementation of this model in the trajectory of LT recipients at the CHUM may allow for better monitoring and health of patients undergoing transplantation, ultimately reducing the average length of hospital stay and promoting better use of medical resources. In the event of positive results, this model could be transposed to all transplant units at the CHUM and across Quebec (potentially affecting 888 patients per year) but could also be applied more widely to the monitoring of patients with other chronic diseases. The lessons learned from this project will be shared with decision makers and will serve as a model for other initiatives involving accompanying patients, connected objects, or digital platforms.
UNASSIGNED: PRR1-10.2196/54440.
摘要：
背景：肝移植（LT）适用于没有其他治疗方法的严重急性或慢性肝衰竭患者。随着近年来LTs数量的不断增加,全世界的肝脏中心必须根据患者的临床情况和移植的预期等待时间来管理患者.蒙特利尔大学中心医院（CHUM）的LT诊所正在开发一种新的医疗保健模式，pery-,以及由跨学科团队进行患者监测的移植后护理，包括陪同的患者;托管临床计划的数字平台;学习程序;以及从连接的对象收集数据。
目的：本研究旨在（1）评估实施带有连接设备和陪同患者的患者平台后的结果，(2)确定实施障碍和促进者，(3)根据健康结果以及与陪同患者接触的比率和性质描述服务结果，（4）描述患者的结果，(5)评估干预措施的成本效益。
方法：研究中将包括六种类型的参与者：（1）在2023年9月之前接受移植并在移植后达到1年的患者（历史队列或对照组），（2）将在2023年12月至2024年11月之间接受LT的患者（前瞻性队列/干预组），（3）这些患者的亲属，（4）已接受LT并有兴趣支持将接受LT的患者的陪同患者，（5）卫生保健专业人员，（六）决策者。描述研究样本并收集数据以实现所有目标，一系列经过验证的问卷，伴随患者日志，采访和焦点小组的记录，和临床指标将在整个研究中收集。
结果：总计，5(转向,教育,临床技术，护士处方,和陪同患者)的工作委员会已经成立。预计将于2023年11月开始招募患者。所有问卷和技术平台都已准备好,和临床医生，利益相关者，并招募了陪同患者的人员。
结论：在CHUM的LT受者的轨迹中实施该模型可以更好地监测接受移植的患者的健康状况，最终减少平均住院时间，促进更好地利用医疗资源。如果取得积极成果，该模型可以转移到CHUM和魁北克的所有移植单位(每年可能影响888名患者),但也可以更广泛地应用于其他慢性病患者的监测.从该项目的经验教训将与决策者分享，并将作为其他涉及陪同患者的举措的模型，连接的对象,或数字平台。
■PRR1-10.2196/54440。
目的：本研究旨在（1）评估实施带有连接设备和陪同患者的患者平台后的结果，(2)确定实施障碍和促进者，(3)根据健康结果以及与陪同患者接触的比率和性质描述服务结果，（4）描述患者的结果，(5)评估干预措施的成本效益。
方法：研究中将包括六种类型的参与者：（1）在2023年9月之前接受移植并在移植后达到1年的患者（历史队列或对照组），（2）将在2023年12月至2024年11月之间接受LT的患者（前瞻性队列/干预组），（3）这些患者的亲属，（4）已接受LT并有兴趣支持将接受LT的患者的陪同患者，（5）卫生保健专业人员，（六）决策者。描述研究样本并收集数据以实现所有目标，一系列经过验证的问卷，伴随患者日志，采访和焦点小组的记录，和临床指标将在整个研究中收集。
结果：总计，5(转向,教育,临床技术，护士处方,和陪同患者)的工作委员会已经成立。预计将于2023年11月开始招募患者。所有问卷和技术平台都已准备好,和临床医生，利益相关者，并招募了陪同患者的人员。
结论：在CHUM的LT受者的轨迹中实施该模型可以更好地监测接受移植的患者的健康状况，最终减少平均住院时间，促进更好地利用医疗资源。如果取得积极成果，该模型可以转移到CHUM和魁北克的所有移植单位(每年可能影响888名患者),但也可以更广泛地应用于其他慢性病患者的监测.从该项目的经验教训将与决策者分享，并将作为其他涉及陪同患者的举措的模型，连接的对象,或数字平台。
■PRR1-10.2196/54440。
